Tieszen, Jerel E

Tieszen, Jerel E is an individual health care provider with primary practice located at 1205 S Grange Ave Ste 510, Sioux Falls SD 57105-0410. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Tieszen, Jerel E can be contacted via phone (605) 328-7500.

Contact Information

Primary practice address
1205 S Grange Ave Ste 510 Sioux Falls SD 57105-0410
Fax: (605) 328-7599
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 1158 South Dakota

Profile Details

NPI number 1730184623
LBN Legal business name Tieszen, Jerel E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2005
Last updated Nov 4th, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1730184623 NPPES
South Dakota MEDICAID 6000953

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